Korean J Urol.  2004 Mar;45(3):240-244.

Variable Findings of Urodynamic Study in Patients with Cerebrovascular Accident Diagnosed as Detrusor Hyperreflexia

• Lee JH
• Kim YJ
• Lee CH

Abstract

PURPOSE: We classified DH(detrusor hyperreflexia) into variable urodynamic findings as DHIC(detrusor hyperreflexia with impaired contractility), DHDP(detrusor hyperreflexia with dyssynergia pattern), and NCDDH(non-impaired contractility < non-dyssynergia pattern detrusor hyperreflexia). The aim of this study was to elucidate the reliability of the difference among the classified DH through a urodynamic study.
MATERIALS AND METHODS
Sixty-nine patients showed DH, which was defined as an involuntary detrusor contraction of more than 15cmH2O with involuntary urine leakage with only a cerebrovascular accident (CVA), by urodynamic study. We classified DH(n=69) into three subgroups as DHIC(n=22)(Pdet.max<30cmH2O, Qmax<12ml/s), DHDP (n=19)(Pdet.max>50cmH2O, Qmax<12ml/s), and NICNDP-DH(n=28).
RESULTS
Mean fraction of voided volume of DHIC(41.7+/-1.8%) and DHDP (38.3+/-2.2%) were significantly less than that of NCDDH (98.5+/-3.2%) according to the urodynamic study (p<0.01). Mean voiding pressure was 25.8+/-0.7cmH2O in DHIC, which was significantly less. However, 96.3+/-10.4cmH2O in DHDP was significantly more than that of NCDDH(p<0.01). Mean age was 83.8+/-1.2 years old in DHIC, which was significantly older than the mean age of the other groups(p=0.01).
CONCLUSIONS
Variable findings of the urodynamic study were found in patients with DH as clinical parameters. Thus, we must treat the DH patients with individual therapy based on urodynamic findings.

Keyword

Cerebrovascular accident; Urodynamics; Hyperreflexia

MeSH Terms

Ataxia
Humans
Reflex, Abnormal*
Stroke*
Urodynamics*